Natalie Wilson, Mohamed Abdallah, Fouad Jaber, Willie Mohammed Johnson, Nicholas McDonald, Michelle Baliss, Shailendra Singh, Mohammad Bilal
PURPOSE: The over-the-scope endoscopic suturing system (ESS) (OverStitch™) is one of the most widely utilized endoscopic suturing systems in current clinical practice; however, data on the adverse events associated with this device is scarce. Our study aims to evaluate the adverse events and complications associated with the over-the-scope ESS using the FDA's Manufacturer and User Facility Device Experience (MAUDE) database.
MATERIALS AND METHODS: We analyzed the post-marketing surveillance data from the FDA MAUDE database for the over-the-scope ESS from January 2008 through June 2022.
RESULTS: Eighty-three reports were filed from January 2008 to June 2022. Adverse events were classified as device-related complications and patient-related adverse events. Seventy-seven device-related issues and 87 patient adverse events were identified. The most common device-related issue was difficulty to remove after deployment (n=12, 15.58%) followed by mechanical problem (n=10, 12.99%), mechanical jam (n=9, 11.69%), or entrapment of device (n=9, 11.69%). Of the 87 patient-related adverse events, the most common was perforation (n=19; 21.84%), followed by device embedded in tissue or plaque (n=10; 11.49%), and abdominal pain (n=8; 9.20%). Of the 19 patients who experienced perforation, two required open surgical repair and one required laparoscopic surgical repair.
CONCLUSION: The overall adverse events from the over-the-scope ESS remain acceptable as evidenced by the number of reported cases since 2008. However, it is important to note that adverse event rates might increase as the use of the device increases; therefore, it is essential for endoscopists to be aware of the potential common and rare adverse events associated with the use of the over-the-scope ESS device.
Kantsevoy SV. The development of the overstitch system and its potentials. Gastrointest Endosc Clin N Am. 2020;30(1):107–14. https://doi.org/10.1016/J.GIEC.2019.08.004 .
[DOI:
10.1016/J.GIEC.2019.08.004]
Stavropoulos SN, Modayil R, Friedel D. Current applications of endoscopic suturing. World J Gastrointest Endosc. 2015;7(8):777. https://doi.org/10.4253/WJGE.V7.I8.777 .
[DOI:
10.4253/WJGE.V7.I8.777]
Watson RR. The use of the overstitch for bariatric weight loss. https://doi.org/10.1016/j.giec.2019.08.005
Juzgado D, Sanchez-Yague A. The use of the overstitch beyond bariatric endoscopy a pictorial description. https://doi.org/10.1016/j.giec.2019.08.009
Kolb JM, Hammad H. The use of the overstitch to close endoscopic resection defects. Gastrointest Endosc Clin N Am. 2020;30(1):163. https://doi.org/10.1016/J.GIEC.2019.08.006 .
[DOI:
10.1016/J.GIEC.2019.08.006]
Banerjee S, Barth BA, Bhat YM, et al. Endoscopic closure devices. Gastrointest Endosc. 2012;76(2):244–51. https://doi.org/10.1016/J.GIE.2012.02.028 .
[DOI:
10.1016/J.GIE.2012.02.028]
Ge PS, Thompson CC. The use of the overstitch to close perforations and fistulas. Gastrointest Endosc Clin N Am. 2020;30(1):147. https://doi.org/10.1016/J.GIEC.2019.08.010 .
[DOI:
10.1016/J.GIEC.2019.08.010]
Chon SH, Toex U, Plum PS, et al. Efficacy and feasibility of OverStitch suturing of leaks in the upper gastrointestinal tract. Surgical Endoscopy. 2020;34(9):3861–9. https://doi.org/10.1007/S00464-019-07152-8/TABLES/3 .
[DOI:
10.1007/S00464-019-07152-8/TABLES/3]
Kantsevoy S v, Bitner M, Mitrakov AA, Thuluvath PJ. Endoscopic suturing closure of large mucosal defects after endoscopic submucosal dissection is technically feasible, fast, and eliminates the need for hospitalization (with videos). https://doi.org/10.1016/j.gie.2013.10.051
Granata A, Amata M, Ligresti D, Bonsignore P, Li Petri S, Traina M. Underwater full-thickness resection of a duodenal bulb gastrointestinal stromal tumor with OverStitch defect repair. Endoscopy. 2019;51(8):E207–8. https://doi.org/10.1055/A-0881-2702 .
[DOI:
10.1055/A-0881-2702]
Singh S, Hourneaux de Moura DT, Khan A, Bilal M, Ryan MB, Thompson CC. Safety and efficacy of endoscopic sleeve gastroplasty worldwide for treatment of obesity: a systematic review and meta-analysis. Surg Obes Relat Dis. 2020;16(2):340–51. https://doi.org/10.1016/J.SOARD.2019.11.012 .
[DOI:
10.1016/J.SOARD.2019.11.012]
Callahan ZM, Su B, Kuchta K, et al. Endoscopic suturing results in high technical and clinical success rates for a variety of gastrointestinal pathologies. J Gastrointest Surg. 2020;24(2):278–87. https://doi.org/10.1007/S11605-019-04485-6/TABLES/9 .
[DOI:
10.1007/S11605-019-04485-6/TABLES/9]
Watson RR. The use of the overstitch for bariatric weight loss. https://doi.org/10.1016/j.giec.2019.08.005
Maselli DB, Alqahtani AR, Abu Dayyeh BK, et al. Revisional endoscopic sleeve gastroplasty of laparoscopic sleeve gastrectomy: an international, multicenter study. Gastrointest Endosc. 2021;93(1):122–30. https://doi.org/10.1016/J.GIE.2020.05.028 .
[DOI:
10.1016/J.GIE.2020.05.028]
Granata A, Amata M, Martino A, et al. Full-thickness gastric plication with Overstitch endoscopic suturing device for postsurgical chronic gastroparesis. Endoscopy. 2020;52(7):E235–6. https://doi.org/10.1055/A-1076-0652 .
[DOI:
10.1055/A-1076-0652]
Stier C, Chiappetta S. Endoluminal revision (OverStitch (TM), Apollo Endosurgery) of the dilated gastroenterostomy in patients with late dumping syndrome after proximal Roux-en-Y gastric bypass. Obes Surg. 2016;26(8):1978–84. https://doi.org/10.1007/S11695-016-2266-1 .
[DOI:
10.1007/S11695-016-2266-1]
Li X, Peng L, Zhang G. Successful anti-reflux treatment post-esophagectomy using endoscopic suturing with Overstitch. Dig Endosc. 2019;31(2):e40–1. https://doi.org/10.1111/DEN.13316 .
[DOI:
10.1111/DEN.13316]
Nagase H, Yamasaki M, Yanagimoto Y, et al. Successful endoscopic treatment of post-esophagectomy refractory reflux using overstitch: the first clinical case. Clin Med Insights Gastroenterol. 2018;11. https://doi.org/10.1177/1179552218784946
Maselli R, Palma R, Traina M, et al. Endoscopic suturing for gastrointestinal applications: initial results from a prospective multicenter European registry. Gastrointest Endosc. Published online June 2022. https://doi.org/10.1016/J.GIE.2022.06.004
Vargas EJ, Bazerbachi F, Rizk M, et al. Transoral outlet reduction with full thickness endoscopic suturing for weight regain after gastric bypass: a large multicenter international experience and meta-analysis. Surg Endosc. 2018;32(1):252–9. https://doi.org/10.1007/S00464-017-5671-1 .
[DOI:
10.1007/S00464-017-5671-1]